Abstract

The objective of this study was to explore personal experiences of change of people diagnosed with borderline personality disorder (BPD) who had partaken in psychological therapy. The aim was to develop the first model of change grounded in service user experience so that this could inform recovery-oriented practice in relation to this client group. A constructivist grounded theory design was chosen. Eight people with a diagnosis of BPD who had completed group-based therapy programmes or were currently attending a peer support group were interviewed about their experiences of change using a semi-structured, open-ended format. An initial model was developed and refined through triangulation with three published accounts of experiences of change in the context of a BPD diagnosis. ‘Discovering “new ways of being” in interpersonal space’ was conceptualised as the core process underpinning pertinent activities and experiences relating to change in people diagnosed with BPD. This interactive, relational process was facilitated in environments that were felt to be both containing and open to conflict. It involved increasing levels of self-disclosure, information exchange, exploration of mental states, experimentation with new behaviours and the consolidation of new ways of being. The core process appeared to extend beyond the therapeutic setting if supported through a relationship with a secure base. Regardless of therapeutic allegiance, effective interventions for people diagnosed with BPD might share a common core change process. Further research is required into change processes in the context of individual psychological therapies and negative therapeutic experiences.